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Talking therapies could be offered to treat menopause symptoms

NICE recommends cognitive behavioural therapy (CBT) alongside or as an alternative to HRT to alleviate the effects of the menopause

A new report by the National Institute of Health and Care excellence (NICE) found that cognitive behavioural therapy (CBT) can help with a range of menopause symptoms.

CBT techniques like paced breathing, stress management, individual and group talking therapy sessions can help with hot flushes, and sleep and mood changes.

The guidance is not mandatory, but NICE suggests taking the recommendation ‘fully into account’ and considered ‘alongside or as an alternative to hormone replacement therapy (HRT)’.

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‘Having more treatment options for managing menopause symptoms and a wider understanding of the risks and benefits of HRT would help ensure that anyone going through menopause can choose the best care to suit them,’ said Jonathan Benger, chief medical officer at NICE.

However, some medical professionals have expressed concern.

‘Current pressures in the NHS mean that GPs and their patients affected by mental health issues struggle to get access to CBT. Women seeking CBT to deal with menopause symptoms would face very long waits,’ said Dr Nighat Arif, a GP specialising in women’s health.

‘It’s also important that this does not distract from the need to make sure that women who need HRT can access it,’ she said.

The guidance reports the risk of ovarian and breast cancer, blood clots and dementia with long term use of HRT.

While these risks are important to consider, thousands of women have benefited from the drugs to treat their symptoms.

‘CBT may have a place when taking a holistic approach to managing the perimenopause, but it won't improve every menopause symptom and won't treat the underlying hormone deficiency,’ said Dr Louise Newson, a GP and menopause specialist.

She said some of the potentially positive effects of HRT on conditions such as heart disease and clinical depression were missing from the document.

Nonetheless, the guidance has been welcomed as a critical step in assessing treatments to help women manage menopause.

‘It’s always helpful for GPs to have access to a range of potential treatments and interventions to help women manage menopause,’ said Professor Kamila Hawthorne, chair of the Royal College of GPs.

‘HRT has been shown to be safe and effective for some women, but it isn’t suitable for everyone, and it’s good to see NICE exploring other options, that evidence suggests may be of benefit, such as CBT,’ she said.

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